Correlation between FLACC scale score and analgesic requirement in children undergoing minimally invasive surgery
https://doi.org/10.4081/pmc.2023.288
Accepted: 17 April 2023
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Postoperative pain presents several challenges in pediatric minimally invasive surgery (MIS). The Faces, Legs, Activity, Cry, and Consolability (FLACC) scale is a valid scale for pediatric postoperative pain. The aim of our study was to assess postoperative pain using FLACC scale and to analyze the correlation between FLACC scale score and analgesic requirement in children underwent MIS. We retrospectively analyzed data of 153 children aged 2 months-3 years who underwent MIS in our unit from January 2019 and December 2019. Postoperative pain assessment was established using FLACC scale. In each patient were analyzed the correlation between FLACC score and analgesic requirement. Pain evaluation was assigned immediately after surgery and at 15 and 60 minutes. 36.6% of patients (56 children) were asleep so considered pain free; 21.6% of patients (33 children) had a FLACC score more than 7 so they required analgesics and the pain assessment 15 and 60 minutes after was significantly lower. 41.8% of patients (64 children) had a postoperative FLACC score less than 3, so they didn’t require any analgesic treatment. On the basis of our results, we recommend FLACC scale for postoperative pain assessment in children underwent MIS aged 2 months-3 years. FLACC scale is an effective and precise scale in detection of postoperative analgesic requirement in children and it could be extended in different age groups with further research.
Babl FE, Crellin D, Cheng J. The use of the faces, legs, activity, cry and consolability scale to assess procedural pain and distress in young children. Pediatr Emerg Care 2012;28:1281–96. DOI: https://doi.org/10.1097/PEC.0b013e3182767d66
Chan JY, von Baeyer CL. Cognitive developmental influences on the ability of preschool-aged children to self-report their pain intensity. Pain 2016;157:997–1001. DOI: https://doi.org/10.1097/j.pain.0000000000000476
Esposito C, Escolino M, Cortese G, et al. Twenty year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs. Surg Endosc 2017;31:1461-8. DOI: https://doi.org/10.1007/s00464-016-5139-8
Esposito C, Escolino M, Corcione F, et al. Twenty year experience with laparoscopic and retroperitoneoscopic nephrectomy in children: considerations and details of technique. Surg Endosc 2016;30:2114-8. DOI: https://doi.org/10.1007/s00464-015-4472-7
Esposito C, Masieri L, Castagnetti M, et al. Robot assisted vs laparoscopic pyeloplasty in children with ureteropelvic junction obstruction (UPJO): technical considerations and results. J Pediatr Urol 2019;15:667.e1-667.e8. DOI: https://doi.org/10.1016/j.jpurol.2019.09.018
Esposito C, Escolino M, Lopez M, et al. Surgical Management of Pediatric Vesicoureteral Reflux: A Comparative Study Between Endoscopic, Laparoscopic, and Open Surgery. J Laparoendosc Adv Surg Tech A 2006;26:574-80. DOI: https://doi.org/10.1089/lap.2016.0055
Johnston CC, Stevens B, Craig KD, Grunau RV. Developmental changes in pain expression in premature, full-term, two- and four- month-old infants. Pain 1993;52:201–8. DOI: https://doi.org/10.1016/0304-3959(93)90132-9
Johansson M, Kokinsky E. The comfort behavioural scale and the modified FLACC scale in paediatric intensive care. Nurs Crit Care 2009;14:122–30. DOI: https://doi.org/10.1111/j.1478-5153.2009.00323.x
Gilbert CA, Lilley CM, Craig KD, et al. Postoperative pain expression in preschool children: validation of the child facial coding system. Clin J Pain 1999;15:192–200. DOI: https://doi.org/10.1097/00002508-199909000-00006
Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 1997;23:293-7.
Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the Face, Legs, Activity, Cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use? Pain 2015;156:2132-51. DOI: https://doi.org/10.1097/j.pain.0000000000000305
Willis MH, Merkel SI, Voepel-Lewis T, Malviya S. FLACC behavioral pain assessment scale: a comparison with the child’s self-report. Pediatr Nurs 2003;29:195-8.
Gomez RJ, Barrowman N, Elia S, et al. Establishing intra- and inter-rater agreement of the face, legs, activity, cry, consolability scale for evaluating pain in toddlers during immunization. Pain Res Manag 2013;18:124–8. DOI: https://doi.org/10.1155/2013/897104
Stalnikowicz R, Mahamid R, Kaspi S. Undertreatment of acute pain in the emergency department: a challenge. Int J Qual Health Care 2005;17:173–6. DOI: https://doi.org/10.1093/intqhc/mzi022
Fournier-Charriere E, Tourniaire B , Carbajal R, et al. EVENDOL, a new behavioral pain scale for children ages 0 to 7 years in the emergency department: design and validation. Pain 2012;153:1573–82. DOI: https://doi.org/10.1016/j.pain.2012.02.024
Voepel-Lewis T, Zanotti J, Dammeyer JA, Merkel S. Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care 2010;19:55–61. DOI: https://doi.org/10.4037/ajcc2010624
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